Unique islet transplant offers Colorado toddler hope

by Cherie Lytle, The Nebraska Medical Center

The two key UNMC physicians in the procedure — Drs. Jean Botha and Brian Stevens — flank Shirley and Leonard Goldstein, an Omaha couple who has contributed money in support of UNMC’s diabetes research programs.

Three-year-old Berlyn Alfredsen is much like any other little girl. She enjoys wearing her hair in a ponytail. Her eyes light up when she watches her favorite Elmo videos. And, brightly colored pictures decorate her room. Unlike other children, though, little Berlyn has spent much of her young life in and out of hospitals. She recently became the youngest patient known to undergo an autologous islet transplant.

The innovative procedure occurred April 6, at The Nebraska Medical Center, performed by a talented team of transplant surgeons and scientists under the leadership of R. Brian Stevens, M.D., Ph.D., and Jean Botha, M.D.

“This was quite an extraordinary process which required a truly multi-disciplinary approach,” said Dr. Stevens, director of the islet cell transplant program at UNMC and The Nebraska Medical Center. “This isn’t a procedure that would normally be performed on such a young child but Berlyn’s struggle with pancreatitis was rapidly becoming more and more critical.”

In severe cases of pancreatitis when the condition becomes chronic, the only real solution is to remove the entire pancreas. Dr. Botha, director of hepatobiliary surgery at The Nebraska Medical Center and assistant professor of surgery at UNMC, recommended the surgery to Berlyn’s family. “Her flare-ups were lasting days, even weeks, causing terrible pain,” Dr. Botha said. “The disease was resulting in almost weekly admissions to the hospital. This would have resulted in progressive fibrosis and scarring of her pancreas. Eventually it would no longer function or produce the insulin needed to regulate sugar levels in her body.”

As they considered the most effective course of treatment, Drs. Botha and Stevens also determined Berlyn would be a good candidate for the islet transplant.

“Without the transplant, we were certain this little girl would become a ‘brittle diabetic’ meaning she would have the most severe form of diabetes – one that is exceedingly difficult if not impossible to manage. It was a very frightening prospect considering she’s just 3-years-old,” Dr. Stevens said. “In removing the pancreas and infusing islets into the liver, we hoped at the very least to keep her blood sugar levels better controlled.”